Heart Failure Is Associated with Increased Risk of Long-Term Venous Thromboembolism

다국어 초록 (Multilingual Abstract)

Background and Objectives: Venous thromboembolism (VTE), consisting of deep vein thrombosis (DVT) and pulmonary embolism (PE), is highly prevalent in in-hospital HF patients and contributes to worse prognoses. However, the risk of VTE in out-patients with HF in long-term period is controversial. This study aimed to evaluate the associations between HF and the risk of VTE in a long-term follow-up duration.
Methods: We searched for studies investigating the risk of VTE, PE, and DVT in patients with HF before April 15, 2020, in PubMed, MEDLINE, and Embase databases. Cohort studies and post hoc analysis of RCTs were eligible for inclusion if they reported relative risk of VTE, DVT or PE in patients with HF in more than 3-month follow-up period.
Results: We identified 31 studies that enrolled over 530,641 HF patients. Overall, patients with HF were associated with an increased risk of VTE (risk ratio [RR]=1.57, 95% confidence interval [CI]=1.34–1.84) and PE (RR=2.00, 95% CI=1.38–2.89). However, the risk of DVT was not significantly increased in HF patients (RR=1.33, 95% CI=0.67–2.63). Subgroup analysis showed that patients with chronic HF (RR=1.54, 95% CI=1.32–1.80) had a higher risk of VTE than those with acute HF (RR=0.95, 95% CI=0.68–1.32).
Conclusions: In conclusion, HF was an independent risk for VTE and PE but not DVT in a long-term follow-up period. Patients with chronic HF were prone to suffer from VTE than acute HF.

참고문헌 (Reference)

1 Imberti D, "Venous thromboembolism prevention in patients with heart failure : an often neglected issue" 36 : 69-74, 2008

2 Ng TM, "Venous thromboembolism in hospitalized patients with heart failure : incidence, prognosis, and prevention" 3 : 165-173, 2010

3 Goldhaber SZ, "Venous thromboembolism in heart failure patients : pathophysiology, predictability, prevention" 75 : 159-162, 2020

4 Klein L, "Thromboembolic risk in the patient with heart failure" 9 : 310-317, 2007

5 Ambrosy AP, "The global health and economic burden of hospitalizations for heart failure : lessons learned from hospitalized heart failure registries" 63 : 1123-1133, 2014

6 Beemath A, "Risk of venous thromboembolism in patients hospitalized with heart failure" 98 : 793-795, 2006

7 Khera R, "Rising mortality in patients with heart failure in the United States : facts versus fiction" 6 : 610-612, 2018

8 Suratkal V, "Right atrial thrombus and challenges in its management" 66 : 65-68, 2018

9 Alikhan R, "Prevention of venous thromboembolism in medical patients with enoxaparin : a subgroup analysis of the MEDENOX study" 14 : 341-346, 2003

10 Hao G, "Prevalence of heart failure and left ventricular dysfunction in China : the China Hypertension Survey, 2012-2015" 21 : 1329-1337, 2019

11 Harjola VP, "Organ dysfunction, injury and failure in acute heart failure : from pathophysiology to diagnosis and management. A review on behalf of the Acute Heart Failure Committee of the Heart Failure Association(HFA)of the European Society of Cardiology(ESC)" 19 : 821-836, 2017

12 Stroup DF, "Meta-analysis of observational studies in epidemiology : a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology(MOOSE)group" 283 : 2008-2012, 2000

13 Yang H, "Management of tunneled-cuffed catheter-related right atrial thrombosis in hemodialysis patients" 68 : 1491-1498, 2018

14 Long B, "Left ventricular assist devices and their complications : a review for emergency clinicians" 37 : 1562-1570, 2019

15 Lim YP, "Increased risk of deep vein thrombosis and pulmonary thromboembolism in patients with organophosphate intoxication: a nationwide prospective cohort study" 94 : e341-, 2015

16 Fanola CL, "Incident heart failure and long-term risk for venous thromboembolism" 75 : 148-158, 2020

17 Darze ES, "Incidence and clinical predictors of pulmonary embolism in severe heart failure patients admitted to a coronary care unit" 128 : 2576-2580, 2005

18 Rokosh RS, "High prevalence and mortality associated with upper extremity deep venous thrombosis in hospitalized patients at a tertiary care center" 65 : 55-65, 2020

19 Tang L, "Heart failure and risk of venous thromboembolism : a systematic review and meta-analysis" 3 : e30-44, 2016

20 Rogers C, "Heart failure : pathophysiology, diagnosis, medical treatment guidelines, and nursing management" 50 : 787-799, 2015

21 Heit JA, "Epidemiology of venous thromboembolism" 12 : 464-474, 2015

22 Cohen AT, "Efficacy and safety of fondaparinux for the prevention of venous thromboembolism in older acute medical patients : randomised placebo controlled trial" 332 : 325-329, 2006

23 Deeks JJ, "Cochrane Handbook for Systematic Reviews of Interventions" Cochrane Collaboration 241-284, 2019

24 Citla Sridhar D, "Central venous catheter-related thrombosis in children and adults" 187 : 103-112, 2020

25 Zghaib T, "Atrial dysfunction in arrhythmogenic right ventricular cardiomyopathy" 11 : e007344-, 2018

26 Greenberg B, "Association of rivaroxaban with thromboembolic events in patients with heart failure, coronary disease, and sinus rhythm : a post hoc analysis of the COMMANDER HF trial" 4 : 515-523, 2019

27 Huang Y, "Association between prediabetes and risk of cardiovascular disease and all cause mortality: systematic review and meta-analysis" 355 : i5953-, 2016

28 Ponikowski P, "2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure : the task force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology(ESC)developed with the special contribution of the Heart Failure Association(HFA)of the ESC" 37 : 2129-2200, 2016